More Bad News For Low Back Pain Sufferers:
Drug-induced Meningitis
The Chiro.Org Blog
SOURCE: Associated Press ~ Oct 4, 2012
By MIKE STOBBE
Medication Linked to Meningitis Deaths May Have Reached 23 States
The
potential scope of the meningitis outbreak that has killed at least
five people widened dramatically Thursday as health officials warned
that hundreds, perhaps thousands, of patients who got steroid back
injections in 23 states could be at risk.
UPDATE: October 09, 2012: The number of identified cases has reached 119, with 11 deaths in 10 different states.
UPDATE: October 11, 2012: The number of identified cases has reached 170, with 14 deaths in 11 different states.
UPDATE: October 12, 2012: from MedScape
The number of people exposed to potentially contaminated
methylprednisolone acetate produced by the New England Compounding
Center (NECC) in Framingham, Massachusetts, is closer to 14,000 — not
13,000 — as originally reported on October 8, federal health officials
said today.
“These 14,000 patients received the medication as a steroid injection
either into the spinal area or into a joint space such as a knee,
shoulder or ankle,” said J. Todd Weber, MD, incident manager of the
multistate meningitis outbreak at the Centers for Disease Control and
Prevention (CDC). More than 12,000 of these people have been contacted
to date, he said.
As of today, the CDC said a total of 170 cases (including the 14
deaths) have been reported across 11 states: Florida (7 cases, 2
deaths), Idaho (1 case), Indiana (21 cases, 1 death), Maryland (13
cases, 1 death), Michigan (39 cases, 3 deaths), Minnesota (3 cases), New
Jersey (2 cases), North Carolina (2 cases), Ohio (3 cases), Tennessee
(49 cases, 6 deaths), and Virginia (30 cases, 1 death).
UPDATE: October 25, 2012: from MedScape
There are currently 328 reported cases of fungal infection, with 24
deaths now reported in 18 states. This includes 5 peripheral joint
infections.
NEW YORK (AP) — The potential scope of the
meningitis outbreak that has killed at least five people widened
dramatically Thursday as health officials warned that hundreds, perhaps
thousands, of patients who got steroid back injections in 23 states
could be at risk.
Clinics and medical centers rushed to contact patients who may have
received the apparently fungus-contaminated shots. And the Food and Drug
Administration urged doctors not to use any products at all from the
Massachusetts pharmacy that supplied the suspect steroid solution.
It is not clear how many patients received tainted injections, or even whether everyone who got one will get sick.
So far, 35 people in six states — Tennessee, Virginia, Maryland,
Florida, North Carolina and Indiana — have contracted fungal meningitis,
and five of them have died, according to the Centers for Disease
Control and Prevention. All had received steroid shots for back pain, a
highly common treatment.
This is especially disturbing, because
Steroid Injections Offer Minimal Relief for Lower Back Pain
In an alarming indication the outbreak could get a lot bigger,
Massachusetts health officials said the pharmacy involved, the New
England Compounding Center of Framingham, Mass., has recalled three lots
consisting of a total of 17,676 single-dose vials of the steroid,
preservative-free methylprednisolone acetate.
An unknown number of those vials reached 75 clinics and other
facilities in 23 states between July and September, federal health
officials said. Several hundred of the vials, maybe more, have been
returned unused, one Massachusetts official said.
But many other vials were used. At one clinic in Evansville, Ind.,
more than 500 patients got shots from the suspect lots, officials said.
At two clinics in Tennessee, more than 900 patients — perhaps many more —
did.
The investigation began about two weeks ago after a case was
diagnosed in Tennessee. The time from infection to onset of symptoms is
anywhere from a few days to a month, so the number of people stricken
could rise.
Investigators this week
found contamination in a sealed vial of the steroid at the New England
company, according to FDA officials. Tests are under way to determine if
it is the same fungus blamed in the outbreak.
The company has shut down operations and said it is working with regulators to identify the source of the infection.
“Out of an abundance of caution, we advise all health care
practitioners not to use any product” from the company, said Ilisa
Bernstein, director of compliance for the FDA’s Center for Drug
Evaluation and Research.
Tennessee has by far the most cases with 25, including three deaths. Deaths have also been reported in Virginia and Maryland.
Meningitis is an inflammation of the lining of the brain and spinal
cord. Symptoms include severe headache, nausea, dizziness and fever.
The type of fungal meningitis involved is not contagious like the
more common forms. It is caused by a fungus often found in leaf mold and
is treated with high-dose antifungal medications, usually given
intravenously in a hospital.
Robert Cherry, 71, a patient who received a steroid shot at a clinic
in Berlin, Md., about a month ago, went back Thursday morning after
hearing it had received some of the tainted medicine.
“So far, I haven’t had any symptoms … but I just wanted to double
check with them,” Cherry said. “They told me to check my temperature and
if I have any symptoms, I should report straight to the emergency room,
and that’s what I’ll do.”
The New England company is what is known as a compounding pharmacy.
These pharmacies custom-mix solutions, creams and other medications in
doses or in forms that generally aren’t commercially available.
Other compounding
pharmacies have been blamed in recent years for serious and sometimes
deadly outbreaks caused by contaminated medicines.
Two people were blinded in Washington, D.C., in 2005. Three died in
Virginia in 2006 and three more in Oregon the following year. Twenty-one
polo horses died in Florida in 2009. Earlier this year, 33 people in
seven states developed fungal eye infections.
Compounding pharmacies are not regulated as closely as drug manufacturers, and their products are not subject to FDA approval.
A national shortage of many
drugs has forced doctors to seek custom-made alternatives from
compounding pharmacies. The steroid suspected in the outbreak has been
in short supply.
Editor’s Comment: The writer of this article fails
to ponder the facts…if steriods were in such short supply (HA!) then
how did this confounded pharmacy get ahold of them?
The New England company at the center of the outbreak makes dozens of
other medical products, state officials said. But neither the company
nor health officials would identify them.
The company said in a statement Thursday that despite the FDA
warning, “there is no indication of any potential issues with other
products.” It called the deaths and illnesses tragic and added: “The
thoughts and prayers of everyone employed by NECC are with those who
have been affected.”
A 2011 state inspection of the Framingham facility gave the business a clean bill of health.
Associated Press writers Travis Loller in Nashville, Jay Lindsay in
Boston, Randall Chase in Wilmington, Del., and AP chief medical writer
Marilynn Marchione in Milwaukee contributed to this story.
Related posts:
- A Practical Guide to Avoiding Drug-Induced Nutrient Depletion
- Steroid Injections Offer Little Relief for Lower Back Pain
- Low-Back Pain, Leg Pain, and Chronic Idiopathic Testicular Pain
Treated with Chiropractic Care
Parents
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